Articles and Blogs

The Seventh Circuit Court of Appeals just issued its decision in US ex rel. Nelson v. Sanford-Brown, Ltd.. This decision is sure to find its way into briefs and arguments for years to come in False Claims Act (“FCA”) cases. It touched upon many of the different ways a qui tam relator can fail to bring an... READ MORE

On June 15, the Supreme Court of Colorado in Coats v. Dish Network ruled in a 5-1 opinion that Dish Network did not violate Colorado state law when it terminated Coats, a former employee and also a medical marijuana patient, for failing a drug test despite that the failure was caused by off-the-clock medical marijuana... READ MORE

Health-Related Bills Tee-Up for Possible Senate Finance Markup The Senate Finance Committee is expected to mark up a number of health care bills that address issues regarding observation status notification and anti-fraud procedures. Legislation that could potentially be marked up by the committee include: the Preventing and Reducing Improper Medicare and Medicaid Expenditures Act... READ MORE

Overview Recently, the Department of Health & Human Services Office of the Inspector General (“OIG”) issued Advisory Opinion 15-06 addressing a 501(c)(3) charitable organization’s proposed arrangement to provide financial assistance to individuals with certain chronic diseases.  Using donated funds, the organization would assist qualifying individuals with health insurance costs, drug/device therapy costs and other... READ MORE

Now that the summer vacation season is officially upon us, it is important for employers and their nonimmigrant workers to consider the potential risks nonimmigrant workers face when traveling internationally prior to the start date of an approved H-1B petition. According to an informal immigration policy known as the “Last Action Rule,” the last... READ MORE

Executive Summary On June 9, 2015, the U.S. Department of Health and Human Services Office of the Inspector General (“OIG”) released a Fraud Alert (the “Alert”) warning that physicians can face significant liability for entering into compensation arrangements that potentially violate the Federal Anti-Kickback Statute (“AKS”).  Specifically, OIG noted that physicians entering compensation arrangements,... READ MORE

On June 4, 2015, CMS released for public inspection a final rule that makes significant changes to the regulations governing Medicare Shared Savings Program (“MSSP”) ACOs.  The rule, scheduled to be officially published in the Federal Register on June 9, revises numerous functions related to MSSP ACOs and their operations and codifies previous CMS... READ MORE

On June 4 and June 10, the Rural Utilities Service will host webinars focused on the Distance Learning and Telemedicine Grant Program. These webinars will inform participants about the major eligibility and regulatory requirements of the program and provide detailed guidance on how to submit a successful grant application. Click here to learn more.... READ MORE

Health care providers and practitioners in most states are well aware that most Medicaid and CHIP enrollees are members of managed care organizations (“MCOs”). As states have increasingly contracted with and relied on MCOs for their growing Medicaid and CHIP populations, including enrollees who need and use long-term care services, the Centers for Medicare... READ MORE

Finance Committee Passes Bill Increasing Oversight of Medicare Audit Contractors On June 3, the Senate Finance Committee passed a bill that would increase oversight of Medicare audit contractors and streamline appeals functions to expedite the Medicare appeals process. The measure would require CMS to establish incentives for auditors to ensure accuracy and allow multiple pending... READ MORE